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MSWA Bulletin Magazine Summer 2018

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THERMOREGULATION SANDRA WALLACE, MSWA MANAGER STRATEGIC SUPPORT SERVICES AND PROJECTS Regulation of the body temperature is controlled by the autonomic nervous system. Impairments of this mechanism may occur in people with multiple sclerosis (MS). The following discussion may assist those who experience heat sensitivity during the summer months, and at any time when the surrounding temperatures are elevated. The incidence of impaired thermoregulation in people with MS is reported to be between 60% and 90%. This condition presents as inappropriate increases, or decreases, in body temperature. People with MS can be adversely affected by small changes in internal and external temperatures. An increase in the core temperature of people with MS causes reduced nerve conduction velocity. Even small elevations in temperature may aggravate existing MS symptoms temporarily until the core temperature has reduced. Symptoms should return to the baseline within 30 minutes if the cause of the temperature increase has been eliminated. Symptoms which persist for 24 hours or more may be related to a coincidental MS relapse and people with MS should seek medical advice if they are concerned. Symptoms may include blurred vision, change in sensory symptoms, decreased strength and fatigue. Increases in temperature may occur during or following: • Exercise – with or without increased air temperature • A hot shower or bath • Infection or illness causing an increase in body temperature • Driving in a hot car during summer without air conditioning • Sitting in a hot, humid room with little air flow • Sitting quietly in a heated room during winter • Sitting in a hot bath Strategies to minimise symptoms due to an increase in core temperature: • Exercise in a cool environment – consider the time of day, temperature of the pool water 27 degrees • Use a fan or air conditioning in the home and/or car • Exercise regularly for short periods, change the intensity of the exercise program • Maintain hydration by drinking cool water before, during and after exercise plus ice cold water drinks when hot • Wear a cooling neck tie around the neck • Wear a cooling vest before or during exercise (see link below) • Wear loose, light clothing • Cool down with a cool shower after exercise • Do not exercise when unwell • Assess your air conditioning needs before summer and update your home unit if required – refrigerated air conditioning is the most effective (see link below for Energy Subsidy Scheme) Air Conditioning MSWA can assist Members on low incomes with funding towards the purchase of an air conditioner for their home, where they do not currently have one. This funding is made available through the generosity of a Lotterywest grant. Be aware, reverse cycle air conditioning is more effective than evaporative air conditioning. For further information about the grants, and eligibility, contact the MSWA Social Welfare Department on 9365 4835. The Thermoregulatory Subsidy To access the subsidy, the impact of heat must be significant, and the applicant must hold a pensioner concession card, health care card or health care interim voucher. This subsidy is 9/annum as at 1 September 2018 and is paid into your personal account through the Department of Treasury and Finance. It will contribute towards the costs associated with higher-than-normal power usage when running an air conditioner. Payment is made annually, and reapplication is required every two years. Your treating doctor must complete the forms. For further information and application forms please contact the Social Welfare department on 9365 4835 or they can be obtained online at: Revenue/Other_Schemes/Thermoregulatory_Dysfunction_ Application_Form.pdf Alternatively, you can phone the Energy Subsidies Enquiry Line on 9262 1373 Cooling Garments Cooling garments are soaked with water and help to cool the body through the skin and blood circulation. They may be cooled in the refrigerator or simply kept moist for effective cooling. Some cooling vests have inserts that are put in the freezer to cool. Products include neck ties and vests. Further information is available from the MSWA Physiotherapy or Occupational Therapy staff on 9365 4888. Arctic Heat Cooling Vest Coolinit Email Telephone: 9248 5355 or Free call: 1800 88 00 67 References: MS Practice 2009. For Health Professionals MS Australia June 2009 M. Sylvester: Benefits and Strategies of Exercise Prescription for PwMS. MS Society of WA 2010 • Check the air conditioning in your car before summer • Park car in shade, allowing for shift of sun over time • Consider using thermoregulatory bedding (available through Pelican Manufacturing or Nikki G’s) if sleep is affected. Some people find bamboo sheets are also effective 22 | MSWA BULLETIN SUMMER 2018 MSWA BULLETIN SUMMER 2018 | 23